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CCRN Review: Cardiovascular Review

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  • CCRN R: Cardiovascular R
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  • CCRN R: Cardiovascular R

A patient in the ED with complaints of chest pain. The 12-lead EKG shows ST elevation in leads V3 and V4. Occlusion of the affected coronary artery most likely would affect perfusion to which portion of the conduction system? A. Sinoatrial (SA) node B. Bachmann's bundle C. Atrioventricular (AV...

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  • September 16, 2024
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  • CCRN R: Cardiovascular R
  • CCRN R: Cardiovascular R
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CCRN Review: Cardiovascular
Review
A patient in the ED with complaints of chest pain. The 12-lead EKG shows ST
elevation in leads V3 and V4. Occlusion of the affected coronary artery most
likely would affect perfusion to which portion of the conduction system?
A. Sinoatrial (SA) node
B. Bachmann's bundle
C. Atrioventricular (AV) node
D. Bundle of His - answer-LAD so D. bundle of his

Which of the following is the preferred lead for ST segment monitoring for a
patient with a suspected RCA occlusion?

A.I
B. aVR
C. III
D. V1 - answer-c. III

Which of the following is not a manifestation of hypertrophic
cardiomyopathy?

A. Syncope
B. Murmur that increases with squatting
C. Chest pain
D. Sudden cardiac death - answer-*B
Classic manifestations of hypertrophic cardiomyopathy are chest pain,
syncope, and an aortic stenosis type of murmur that decreases when the
patient is in a squatting position. The first manifestation of this condition is
occasionally sudden cardiac death during exercise.

In which quadrant is the mean QRS complex axis located if the QRS complex
is predominantly positive in lead I and negative in lead aVF?

A. Normal quadrant
B. Left axis deviation quadrant
C. Right axis deviation quadrant
D. Indeterminant quadrant - answer-*B
Because the positive of lead I is the left arm, if the QRS complex is upright in
lead I, the mean QRS axis is to the left. Because the positive of lead aVF (a
unipolar lead) is at the foot, if the QRS complex is negative in lead aVF, the
mean QRS axis is upward away from the foot. This axis would be in the
upper left quadrant, described as left axis deviation.

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